Stone Falls Dental Care, LLC

NPI #1174945158 in O Fallon, Illinois

Provider Information

NPI Number: 1174945158
Entity Type: Organization
Organization Name: Stone Falls Dental Care, LLC
Primary Specialty: Dentist
Enumeration Date: Jan 10, 2014
Last Updated: Jul 3, 2014

Practice Location

Address: 4945 STONE FALLS CTR
Address 2: SUITE A
City: O Fallon
State: Illinois
ZIP Code: 62269-7801
Phone: (618) 624-2800

Authorized Official

Name: CARLEIGH PRANE, D.M.D
Title: OWNER
Phone: (618) 624-2800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X
Dentist	122300000X	Primary

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